Treatment of extensively drug-resistant tuberculosis in Tomsk, Russia: a retrospective cohort study

被引:132
作者
Keshavjee, Salmaan [1 ,2 ,3 ]
Gelmanova, Irina Y. [3 ,4 ]
Farmer, Paul E. [1 ,2 ,3 ]
Mishustin, Sergey P. [5 ]
Strelis, Aivar K. [6 ,7 ]
Andreev, Yevgeny G. [8 ]
Pasechnikov, Alexander D. [4 ]
Atwood, Sidney [2 ]
Mukherjee, Joia S. [2 ,3 ]
Rich, Michael L. [2 ,3 ]
Furin, Jennifer J. [2 ,3 ]
Nardell, Edward A. [1 ,2 ,3 ,9 ]
Kim, Jim Y. [1 ,2 ,3 ,9 ]
Shin, Sonya S. [2 ,3 ]
机构
[1] Harvard Univ, Sch Med, Dept Global Hlth & Social Med, Boston, MA 02115 USA
[2] Brigham & Womens Hosp, Div Global Hlth Equ, Boston, MA 02115 USA
[3] Partners Hlth, Boston, MA USA
[4] Partners Hlth, Moscow, Russia
[5] Tomsk Oblast TB Serv, Tomsk, Russia
[6] Siberia State Med Univ, Tomsk, Russia
[7] Tomsk Oblast TB Hosp, Tomsk, Russia
[8] Minist Justice, Tomsk Penitentiary Serv, Tomsk, Russia
[9] Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA
基金
比尔及梅琳达.盖茨基金会; 美国国家卫生研究院;
关键词
D O I
10.1016/S0140-6736(08)61204-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Mycobacterium tuberculosis strains that cause untreatable drug-resistant disease are a threat worldwide. We describe the treatment, management, and outcomes of patients with extensively drug-resistant tuberculosis in Tomsk, Russia. Methods We undertook a retrospective cohort study of 608 patients with multidrug resistant tuberculosis who had treatment in civilian or prison services, between Sept 10, 2000, and Nov 1, 2004, according to the treatment strategy recommended by WHO. Clinical characteristics, management practices, and treatment outcomes of patients with extensively drug-resistant (XDR) tuberculosis and non-extensively drug-resistant (non-XDR) tuberculosis are described. The main outcome was the frequency of poor and favourable outcomes at the end of treatment. Findings Of 608 patients with multidrug resistant tuberculosis, 29 (4.8%) patients had baseline XDR tuberculosis. Treatment failure was more common in patients with XDR tuberculosis than in those with non-XDR tuberculosis (31% vs 8.5%, p=0.0008). 48.3% of patients with XDR tuberculosis and 66.7% of patients with non-XDR tuberculosis had treatment cure or completion (p=0.04). The frequency and management of adverse events did not differ between patients with XDR and non-XDR tuberculosis. Interpretation The chronic features of tuberculosis in these patients suggest that extensively drug-resistant tuberculosis may be acquired through previous treatments that include second-line drugs. Aggressive management of this infectious disease is feasible and can prevent high mortality rates and further transmission of drug-resistant strains of Mycobacterium tuberculosis. Funding Bill & Melinda Gates Foundation, Eli Lilly Foundation, The Open Society Institute, Frank Hatch Fellowships in Global Health Equity at the Brigham & Women's Hospital, Infectious Disease Society of America, the Heiser Foundation, the United States National Institutes of Health, and the John D and Catherine T MacArthur Foundation.
引用
收藏
页码:1403 / 1409
页数:7
相关论文
共 41 条
[1]  
[Anonymous], 2006, GLOBAL TUBERCULOSIS
[2]  
Bender D.A., 1997, Nutrition: A Reference Handbook, DOI DOI 10.1016/j.juro.2007.08.163
[3]   Simultaneous infection with multiple strains of Mycobacterium tuberculosis [J].
Braden, CR ;
Morlock, GP ;
Woodley, CL ;
Johnson, KR ;
Colombel, AC ;
Cave, MD ;
Yang, ZH ;
Valway, SE ;
Onorato, IM ;
Crawford, JT .
CLINICAL INFECTIOUS DISEASES, 2001, 33 (06) :E42-E47
[4]   Treatment and outcome analysis of 205 patients with multidrug-resistant tuberculosis [J].
Chan, ED ;
Laurel, V ;
Strand, MJ ;
Chan, JF ;
Huynh, MLN ;
Goble, M ;
Iseman, MD .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2004, 169 (10) :1103-1109
[5]   Tuberculosis recurrence and mortality after successful treatment:: Impact of drug resistance [J].
Cox, Helen ;
Kebede, Yared ;
Allamuratova, Sholpan ;
Ismailov, Gabit ;
Davletmuratova, Zamira ;
Byrnes, Graham ;
Stone, Christine ;
Niemann, Stefan ;
Ruesch-Gerdes, Sabine ;
Blok, Lucie ;
Doshetov, Daribay .
PLOS MEDICINE, 2006, 3 (10) :1836-1843
[6]   Standard short-course chemotherapy for drug-resistant tuberculosis -: Treatment outcomes in 6 countries [J].
Espinal, MA ;
Kim, SJ ;
Suarez, PG ;
Kam, KM ;
Khomenko, AG ;
Migliori, GB ;
Baéz, J ;
Kochi, A ;
Dye, C ;
Raviglione, MC .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2000, 283 (19) :2537-2545
[7]  
Farmer P, 1999, INT J TUBERC LUNG D, V3, P365
[8]  
FARMER PE, 2000, J RESP DIS, V21, P53
[9]   Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa [J].
Gandhi, Neel R. ;
Moll, Anthony ;
Sturm, A. Willem ;
Pawinski, Robert ;
Govender, Thiloshini ;
Lalloo, Umesh ;
Zeller, Kimberly ;
Andrews, Jason ;
Friedland, Gerald .
LANCET, 2006, 368 (9547) :1575-1580
[10]   Barriers to successful tuberculosis treatment in Tomsk, Russian Federation: non-adherence, default and the acquisition of multidrug resistance [J].
Gelmanova, I. Y. ;
Keshavjee, S. ;
Golubchikova, V. T. ;
Berezina, V. I. ;
Strelis, A. K. ;
Yanova, G. V. ;
Atwood, S. ;
Murray, M. .
BULLETIN OF THE WORLD HEALTH ORGANIZATION, 2007, 85 (09) :703-711